Provider Demographics
NPI:1003809203
Name:IHS ACQUISITION NO 127 INC
Entity Type:Organization
Organization Name:IHS ACQUISITION NO 127 INC
Other - Org Name:MIDWEST CITY NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-513-8738
Mailing Address - Street 1:8200 NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-8518
Mailing Address - Country:US
Mailing Address - Phone:405-737-8200
Mailing Address - Fax:405-736-0583
Practice Address - Street 1:8200 NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-8518
Practice Address - Country:US
Practice Address - Phone:405-737-8200
Practice Address - Fax:405-736-0583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH5552-5552314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100770810AMedicaid
OK100770810AMedicaid